Extracorporeal Circulatory Support for Lung Transplantation: Institutional Experience

Extracorporeal membrane oxygenation as a bridge to lung transplantation in the United States: An evolving strategy in the management of rapidly advancing pulmonary disease

“…[11][12][13][14][15] Recent clinical advances have served to further increase the efficacy and safety of contemporary ECMO use as a whole. 7,16 Many centers have published improved results with ECMO, but, even collectively, these have been based on small numbers. 7,[16][17][18][19] Furthermore, the reports have had mixed conclusions resulting in equivocation and a general lack of consensus.…”

“…7,16 Many centers have published improved results with ECMO, but, even collectively, these have been based on small numbers. 7,[16][17][18][19] Furthermore, the reports have had mixed conclusions resulting in equivocation and a general lack of consensus. 3,4,7,8,[20][21][22][23][24] Nevertheless, the growing trend in recent series is invariably favorable, and supportive evidence in our own practice prompted this national analysis.…”

The Munich Lung Transplant Group: Intraoperative Extracorporeal Circulation in Lung Transplantation

“…3,4,10,11 Though open-circuit CPB and closed-circuit ECMO share the features of unloading the pulmonary circulation, minimizing intraoperative ventilator support and allowing controlled reperfusion, the clear-cut advantages of ECMO over CPB are the possibility to prolong ECMO therapy into the postoperative intensive care and, in particular, to restrict the use of heparin. 3,4,10,11 With that, the strict need for full heparinization for ECC in LuTx is put to test, as it may be a relevant perioperative risk factor. 8,9,14 The MLTG has used CPB with full heparinization for ECC during LuTx, roughly until 2012, but changed to basically only use venoarterial ECMO for ECC during LuTx.…”

“…Such situations may require the intraoperative establishment of extracorporeal circulation (ECC) devices during LuTx. [3][4][5] Traditionally, open-circuit cardiopulmonary bypass (CPB) with mandatory full heparinization is used, as it is a proven effective supportive technique. [5][6][7] However, blood conductance through the circuit activates inflammatory reactions, and the obligatory full heparinization may lead to bleeding complications and coagulation disorders, particularly in surgically complex cases, for example, redo-surgery.…”

Extracorporeal Circulation During Lung Transplantation Procedures: A Meta-Analysis

“…1,2 Intraoperatively, ECC helps to overcome excessive pulmonary hypertension and associated right heart failure after clamping of the pulmonary hilum or global hypoxia and hypercarbia during one lung ventilation. [3][4][5] Whereas in the past, there has been controversy about the benefit and risks of routine ECC use during lutx procedures, there is growing evidence that patients undergoing lutx on ECC support receive more blood products, have longer mechanical ventilation time, and prolonged intensive care unit (ICU) and hospital length of stay. 6 There is a higher risk of bleeding and an elevated need for re-thoracotomies in these patients.…”